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Is treatment for 88-year old Dad too aggressive for his age?
Hello all. I am learning so much from your posts! They are informative, and heartfelt. This is a compassionate group.
I would love to hear your comments on my dad's journey. We - as his children - are torn about his treatment suggestions.
My dad was diagnosed with Stage 4 oligometastatic prostate cancer back in November. Gleason 9/aggressive/entire prostate has cancer, as well as lymphnodes, some perineural invasion, and bone mets in one spot: pelvic bone.
He is being treated at Sloan. He started Orgovyx in early December. Now, his oncologist wants to start Abiraterone 250mg 4 times per day, with Prednisone 5mg once per day. We are meeting with the Sloan radiation oncologist on Tuesday to discuss radiation treatment. (As a side note, we met with another radiation oncologist who said 5 weeks of IMRT to the prostate - not the lymphnodes and not the pelvic met - which surprised me). Radiation will start in approx. 3 months.
Our concern is this: my dad is 88 years old. He is relatively healthy except for a Foley Catheter needed to eliminate urine ( which may resolve if the cancer shrinks from treatment), minor seizure a few years ago for which he is taking meds, and they are working. His heart is good. He is thin - 132 lbs. His mind is still active, and he loves to eat! He wants to LIVE! He loves his life.
He has fatigue which started before the cancer treatment. So we are not sure if his present fatigue is due to the Orgovyx. He has had one hot flash. We worry about starting the abiraterone since this could bring on liver problems, and heart problems. He now has neither.
Are we being too aggressive for his age? We love him, and want him around for a longer time. Oncologist says survival rates are better with 2 meds simultaneously in the beginning. I would appreciate your thoughts! Thank you!!
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Yes, but we could slow it down with serious lifestyle interventions that serious prostate cancer deserves! That is what I am trying to do. When I was first diagnosed last March, I told my oldest daughter (lost my wife December 24, 2020, on her 80th with Idiopathic Pulmonary Fibrosis), I am the right person to get it! She said, what do you mean? I said, "I like the challenge, and I want to win!"
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3 ReactionsYou are probably right - I believe you! How did you handle the radiation?
Agree!
This is what I am concerned about! My dad has never had high blood pressure - why create more problems?
High Blood Pressure can be controlled with diet exercise or medications. It is only uncontrolled high BP is a concern.
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2 ReactionsI'm 75 y/o two years following treatment for prostate cancer, and thankfully with no evidence (yet) of persistence. 35 years ago, and more recently this year, I watched my father and then my brother-in-law go through dying of metastatic (bony) prostate cancer after prolonged "heroic" treatments. To say the least, those were not pleasant experiences for either them or their loved ones. I am currently without any other medical issues - no prescription meds, able to engage in all the activities I could before surgery, etc. Also, I am a retired MD.
All that as preface to my thought, that if I were in your father's place (as I may very well be in 13 years), I would be less focused on the nuances of aggressive treatment, rather primarily focused on "getting my affairs in order", polishing up my bucket list, encouraging my health care team to provide palliative care with the lowest risk of side effects, and investigating physician-assisted suicide ( to know that it was available if/when I wanted it, not to dive right into it), which is legal in my state. But, as they say, YMMV.